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General NPI Number Information
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NPI Number | 1366820532
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Entity Type | Individual
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Provider Name | CARLOS BARBOSA LCSW
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Gender | Male
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Dates
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Enumeration Date | 05/08/2015
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Last Update Date | 07/06/2022
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Provider Practice Location Address
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Address Line | 60 RIVER RD APT S202
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City | BOGOTA
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State | NJ
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Zip | 07603-1531
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Country | US
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Telephone | 201-725-9530
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Fax |
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Provider Business Mailing Address
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Address Line | 400 PASSAIC AVE
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City | KEARNY
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State | NJ
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Zip | 07032-1205
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Country | US
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Telephone | 201-898-0777
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 44SL06000700
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC05787800
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License Number State | NJ
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